There will be a 1.0% Teampages processing fee added to the PayPal total

The League is paying the 3.5% PayPal Fee, which ranges from $15.05 – $23.63 per registrant.

*Parent Name

Name:

*Address:

Street Address: City: State/Province: Country: Zip/Postal Code:

*Phone Number:

*Primary Email Address – This address will be used for league notifications

*Player to be Registered

Name:

*Gender

MaleFemale

*Date of Birth

*Birth Certificate Registration Number: Example 2005-05-093362

*Are Returning Player (You have played in the HHMBA in any of – House League, Rep or Select at any time)?

YesNo

*Rep or Select Team:

Note on Select Team Payments

House League Select Teams consist of players who play both house league and select loop/tournament play. These players must register in BOTH house league and Select and pay the associated fees for both teams. The supplemental fee for House League Select is an additional $275 top of your House League fees.

*If you are registering for Select Programs, Please confirm you have also registered for a House League Program. Please Check this box off to continue

List any medical concerns

Any Special Requests or Comments?

*Emergency Contact

Name:

*Emergency Contact Phone Number:

Release and Discharge (Please Read Carefully and Check Below)

In consideration of accepting the above-mentioned person, I grant him/her permission to participate in the Halton Hills Minor Baseball Association (HHMBA) program(s). For the same consideration, I hereby release and forever discharge the Halton Hills Minor Baseball Association, its Officers, Directors, Conveners, Coaches, Umpires or other Officials and the Town of Halton Hills from all claims, demands, damages, actions or causes of action arising or to arise by any reason because of my son’s/daughter’s participation in any HHMBA program, in this or any successive year(s), including (but without limiting the generality of the foregoing) any and all dental and medical bills and further of and from all claims or demands whatsoever in law or in equity which I, my heirs, executors, administrators or assignors can, shall or may have by reason aforesaid.

*I agree to the release and discharge

Disclaimer

I further agree to abide by the rules, regulations and bylaws of HHMBA, and consent to the use of any and all private information herein provided in accordance with the Personal Information Protection and Electronics Documents Act in this year or any successive years of participation.

*I agree

YesNo

Payment Information

For payments we offer PayPal Online Payments. You may use your existing PayPal account or you may use the One Time Payment option, which will allow a direct Credit Card Payment. Payment portion of registration will take you from our web-page to the PayPal secure payment site. Payments should only be considered complete when you receive an email confirmation from PayPal. Web Payments are subject to a 1% Team Pages Fee which users pay, and a Paypal charge of 3%, which is included in the Registration fee. If you have any payment related technical issues or questions, please contact:reghelp@hhmba.ca